Study to assess neuropathy severity in patients with diabetic foot problems

Background: Diabetic neuropathy is the most common complication of diabetes affecting 50% of the patients with type 1 and type 2 diabetes. Its late sequelae which include foot ulceration, charcot neuroarthropathy and occasionally amputation, should in many cases be preventable. Biothesiometry is a device which can measure the vibration perception threshold and guide the treatment as well as prevent further foot problems in such patients.Methods: In this study we included 65 patients with diabetic foot symptoms by random sampling technique between the age group of 40-75 years. All these patients were subjected to biothesiometer testing. The response was measured as vibration perception threshold (VPT). The variation of VPT in different conditions was established.Results: Among 65 patients, 40(61%) patients had painful sensation, VPT ranging from 16 V to 25 V, 6 (0.09%) patients had callus, dry foot or pigmentation with VPT 25-35 V, 12 (18.4%) patients had callus ulcer with VPT 36-45 V, 3 (0.046%) patients had both ulcer and skin changes with VPT 45-50 V and 4 (0.06%) patients presented with deformity and VPT 50 V.Conclusions: The study concluded that risk of ulceration is high with increased VPT. Hence, early detection of raised VPT would help the clinicians not only to guide the patients about the high risk of ulceration but it as well will help in educating the patient and emphasizing the need for proper glycemic control, proper footwear and foot care.

Acute Effects of a Whole Body Vibration Session on the Vibration Perception Threshold in Patients with Type 2 Diabetes Mellitus

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic disease that affects millions of people, and according to the International Diabetes Federation, 46.5% of people have undiagnosed diabetes. One of the most common complications of diabetes mellitus is loss of peripheral sensation. Whole Body Vibration (WBV) is a therapy, and it would be interesting to know if it can be considered as a training method to improve the Vibration Perception Threshold (VPT). The aim of the study is to verify whether there are really acute effects on the VPT after a WBV training session in people with T2DM. Methods: Ninety people with T2DM (56 men and 34 women) were randomly allocated to two groups: the WBV group and the placebo group. The ninety subjects went through a VPT training test before receiving the assigned intervention, and they performed the VPT test using the Vibratron II device. Results: After one session of WBV, an increase of the VPT in the WBV group was found, with respect to the placebo group. Conclusions: Vibration perception threshold is increased after a WBV training session in people with T2DM, compared to a placebo group.

Association between TUG and Anthropometric Values, Vibration Perception Threshold, FHSQ and 15-D in Type 2 Diabetes Mellitus Patients

Background: Diabetes Mellitus (DM) is a chronic disease and it is characterized by reduced insulin sensitivity and/or impaired insulin production. It affects approximately 415 million people worldwide and involves a variety of complications. DM has a number of complications, including diabetic neuropathy. All of these complications can have effects on body composition, vibration perception threshold (VPT), foot health and health-related quality of life (HRQoL). Objective: The aim of this study is to determine the correlation between the Timed Up and Go (TUG), VPT, Foot Health Status Questionnaire and 15-D Questionnaire in type 2 diabetes mellitus (T2DM) patients. Methodology: A total of 90 T2DM patients (56 men and 34 women) were evaluated on their body composition, VPT, the foot health status through the FHSQ, the HRQoL was evaluated through the 15-D Questionnaire and the TUG test was performed. Results: Statistically significant associations were found between TUG and lean and fat mass, VPT, the sections “General Foot Health” and “Physical Activity” in the FHSQ questionnaire, and the 15D total score and its sections “Mobility” and “Depression”. Conclusions: There is a moderate direct correlation between the Timed Up and Go and the fat mass percentage and the vibration perception threshold. Moreover, there is a moderate inverse correlation between Timed Up and Go and fat-free mass, foot health and health-related quality of life in T2DM patients. Therefore, Timed Up and Go can be a tool to assist clinicians in monitoring and managing T2DM patients.

Test-Retest Reliability of Vibration Perception Threshold Test in People with Type 2 Diabetes Mellitus

Background: Diabetes mellitus is a chronic disease characterized by fasting hyperglycemia. It affects approximately 415 million people worldwide and involves a variety of complications. One of them is the loss of sensitivity to peripheral vibration. Objective: Our study aims to discover the test-retest reliability of a procedure for assessing vibration sensitivity in people with type 2 diabetes mellitus. Methodology: 90 people with type 2 diabetes mellitus (56 men and 34 women) performed the vibration perception threshold (VPT) test using the Vibratron II device. A re-test was completed seven days after the first reading. Results: The relative reliability of the VPT test result is excellent (intraclass correlation coefficient = 0.96). The same applies to gender and obesity subgroups. Regarding absolute reliability, the standard error of measurement is 8.99%, and the small real difference is 24.94%. Conclusions: The relative and absolute reliability results of the vibration perception threshold in people with type 2 diabetes mellitus offer excellent results.